Anyone can become paranoid – that is, develop an irrational fantasy of being betrayed, mocked, exploited or harmed – but we are more likely to become paranoid if we are insecure, disconnected, alone. Above all, paranoid fantasies are a response to the feeling that we are being treated with indifference. In other words, paranoid fantasies are disturbing, but they are a defense. They protect us from a more disastrous emotional state – namely, the feeling that no one is concerned about us, that no one cares. The thought “so-and-so has betrayed me” protects us from the more painful thought “no one thinks about me.” It is less painful to feel betrayed than to feel forgotten.
–Stephen Grosz, The Examined Life: How We Lose and Find Ourselves